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表2 依洛尤单抗在各个国家/组织批准的适应证范围 [ 7 ] ALLARD D,AMSELLEM S,ABIFADEL M,et al. Novel
批准机构 适应证 mutations of the PCSK9 gene cause variable phenotype of
美国FDA 1.预防心血管事件:在已确诊 2.原发性高脂血症(包 3.HoFH:与饮食疗法和其他降 autosomal dominant hypercholesterolemia[J]. Hum Mutat,
CVD的成人中,可降低心肌 括HeFH):单独使用或 低LDL疗法(例如他汀类药物、
梗死、中风和冠状动脉血运重 与其他降脂药物联合 依泽替米贝、LDL血浆置换术) 2005. DOI:10.1002/humu.9383.
建的风险 使用 联合使用 [ 8 ] BURKE AC,DRON JS,HEGELE RA,et al. PCSK9:re-
欧洲EMA 1.高胆固醇血症和混合性血 2.成人或 12 岁以上青 3.ASCVD:联合他汀类药物的 gulation and target for drug development for dyslipi-
脂异常:与饮食疗法合用;使 少年 HoFH:可与饮食 最大耐受剂量±其他降脂药
用他汀类药物±其他降脂药 疗法和其他降脂药物 物;单独使用或与其他降脂药 demia[J]. Annu Rev Pharmacol Toxicol,2016,57(1):
物无法达到LDL-C目标的患 联用 物联合使用 223-244.
者,可以联合使用他汀类药物
的最大耐受剂量;对他汀类药 [ 9 ] ZHANG DW,LAGACE TA ,GARUTI R ,et al. Binding
物不耐受或禁忌的患者单独
使用或与其他降脂药物联合 of proprotein convertase subtilisin/kexin type 9 to epider-
使用 mal growth factor-like repeat A of low density lipoprotein
中国NMPA 1.成人或 12 岁以上青少年 2.成人动脉粥样硬化性 receptor decreases receptor recycling and increases degra-
HoFH:可与饮食疗法和其他 CVD,以降低心肌梗
降脂药物联用 死、卒中和冠状动脉血 dation[J]. J Biol Chem,2007,282(25):18602-18612.
运重建的风险
[10] LAGACE TA,CURTIS DE,GARUTI R,et al. Secreted
安全性和耐受性较好,在推荐剂量下最常见的不良反应 PCSK9 decreases the number of LDL receptors in hepato-
是鼻咽炎、上呼吸道感染、背痛、关节痛、流感和注射部 cytes and in livers of parabiotic mice[J]. J Clin Invest,
位反应 [30-31] 。但是,由于依洛尤单抗的上市时间不长,关 2006,116(11):2995-3005.
[11] AKRAM ON,BERNIER A,PETRIDES F,et al. Beyond
于其疗效和安全性方面的研究还不充分,仍需进行一步
LDL cholesterol,a new role for PCSK9[J]. Arterioscler
深入研究。
Thromb Vasc Biol,2010,30(7):1279-1281.
参考文献
[12] SEIFAH NG,AWAN Z,CHRETIEN M,et al. PCSK9:a
[ 1 ] 中华医学会,中华医学会杂志社,中华医学会全科医学
key modulator of cardiovascular health[J]. Circ Res,2014,
分会,等.血脂异常基层诊疗指南:实践版:2019[J].中华
114(6):1022-1036.
全科医师杂志,2019,18(5):417-422.
[13] CHAN JC,PIPER DE,CAO Q,et al. A proprotein conver-
[ 2 ] ROBINSON JG,NEDERGAARD BS,ROGERS WJ,et al.
tase subtilisin/kexin type 9 neutralizing antibody reduces
Effect of evolocumab or ezetimibe added to moderate-or
serum cholesterol in mice and nonhuman primates[J].
high-intensity statin therapy on LDL-C lowering in pa-
Proc Natl Acad Sci USA,2009,106(24):9820-9825.
tients with hypercholesterolemia:the LAPLACE-2 ran-
[14] GIBBS JP,DOSHI S,KUCHIMANCHI M,et al. Impact
domized clinical trial[J]. JAMA,2014,311(18):1870-
of target-mediated elimination on the dose and regimen of
1882.
evolocumab,a human monoclonal antibody against pro-
[ 3 ] STROES E,COLQUHOUN D,SULLIVAN D,et al. Anti- protein convertase subtilisin/kexin type 9(PCSK9)[J]. J
PCSK9 antibody effectively lowers cholesterol in patients Clin Pharmacol,2017,57(5):616-626.
with statin intolerance:the GAUSS-2 randomized,place- [15] KASICHAYANULA S,GROVER A,EMERY MG,et al.
bo-controlled phase 3 clinical trial of evolocumab[J]. J Clinical pharmacokinetics and pharmacodynamics of evo-
Am Coll Cardiol,2014,63(23):2541-2548. locumab,a PCSK9 inhibitor[J]. Clin Pharmacokinet,
[ 4 ] SABATINE MS,GIUGLIANO RP,KEECH AC,et al. 2018,57(7):769-779.
Evolocumab and clinical outcomes in patients with cardio- [16] KOREN MJ,SCOTT R,KIM JB,et al. Efficacy,safety,
vascular disease[J]. N Engl J Med,2017,376(18):1713- and tolerability of a monoclonal antibody to proprotein
1722. convertase subtilisin/kexin type 9 as monotherapy in pa-
[ 5 ] SEIDAH NG,BENJANNET S,WICKHAM L,et al. The tients with hypercholes-terolaemia (MENDEL):a ran-
secretory proprotein convertase neural apoptosis-regulated domised, double-blind, placebo-controlled, phase 2
convertase 1(NARC-1):liver regeneration and neuronal study[J]. Lancet,2012,380(9858):1995-2006.
differentiation[J]. Proc Natl Acad Sci USA,2003,100 [17] KOREN MJ,LUNDQVIST P,BOLOGNESE M,et al. An-
(3):928-933. ti-PCSK9 monotherapy for hypercholesterolemia:the
[ 6 ] ABIFADE M,VARRET M,RABES JP,et al. Mutations MENDEL-2 randomized,controlledphase Ⅲ clinical trial
in PCSK9 cause autosomal dominant hypercholestero- of evolocumab[J]. J Am Coll Cardiol,2014,63(23):
lemia[J]. Nat Genet,2003,34(2):154-156. 2531-2540.
中国药房 2020年第31卷第23期 China Pharmacy 2020 Vol. 31 No. 23 ·2943 ·